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Biomedical subjects

R W Enzenauer

Publications and source records attributed to R W Enzenauer.

At least 19 recordsLinked to original sources
PubMed2000

Photoscreening for amblyogenic factors by public health personnel: the Eyecor Camera System.

OBJECTIVES: This pilot study was designed to assess the ability of a photoscreening camera to detect amblyogenic factors such as high refractive error, anisometropia, media opacities and strabismus in children, compared to the standard vision screening techniques employed by the local state public health screening personnel. METHODS: Public health personnel in Illinois used the Eyecor prototype to the current commercially available MTI PS-100 photoscreening camera (manufactured by Medical Technology Inc.) to screen 127 non-dilated subjects, ages 7 months to 20 years (mean age, 6 years), for amblyogenic factors. All participants were concurrently subjected to the "standard" vision screening employed routinely by state public health personnel. The study participants included a group of normal inner-city children and one group of special-needs children. The normal children came from both a public school and a private school. The special-needs children included a group of children from a state-run school for the deaf and hard-of-hearing and a separate group of children attending a multi-disciplinary Easter Seals clinic. RESULTS: In the population of normal children, the mean sensitivity and specificity for the observers using the Eyecor Camera system was 81% and 83% with a mean positive predictive value of 83%, and a mean negative predictive value of 55%. Standard vision screening techniques employed by public health service certified vision screeners had a sensitivity of 88%, a specificity of 91%, a positive predictive value of 67% and a negative predictive value of 97% in the same subjects. In the population of special-needs children with hearing impairment and developmental delay, the mean sensitivity and specificity for the observers using the Eyecor Camera system was 74% and 82% with a mean positive predictive value of 69% and a mean negative predictive value of 85%. Standard vision screening techniques employed by public health service certified vision screeners had a sensitivity of 100%, a specificity of 55%, a positive predictive value of 62% and a negative predictive value of 100% in the same subjects. (See Table 1) CONCLUSIONS: This study shows that the Eyecor Photoscreening Camera is useful in screening normal children for amblyogenic factors. Photoscreening was at least as effective as standard screening methodologies performed by certified vision screeners as required by state public health policy. In addition, photoscreening is particularly useful in testing those children "unscreenable" by conventional vision screening procedures.

Adolescent↗
PubMed1999

Residual ethanol content of donor sclera after storage in 95% ethanol and saline rinse of various durations.

PURPOSE: Some surgeons are wary of using alcohol-preserved sclera for allografts because they fear a toxic effect on surrounding tissue after placement. We set out to determine the amount of ethanol remaining in scleral allograft material after storage in 95% ethanol. METHODS: Sixty half scleras from 30 donors were preserved in 95% ethanol for an average of 31+/-14 days (range, 11 to 50 days). Rehydration was performed by soaking each half sclera in 4 ounces of balanced salt solution. Half scleras were randomly assigned to six groups of 10 each. Assays for ethanol were performed on the following groups: no balanced salt solution soak and balanced salt solution soak for 10 minutes, 20 minutes, 30 minutes, 40 minutes, and 50 minutes. Ethanol assay was performed by Headspace Gas Space Chromatography at ChemaTox Laboratory, Inc, Boulder, Colorado. RESULTS: The 10 half scleras without balanced salt solution soak had a mean ( SD) ethanol level of 175+/-14.1 mg per g of sclera. After 10 minutes of balanced salt solution s oak, the level decreased to 7.57+/-1.56 mg per g, then 3.77+/-3.02 mg per g at 20 minutes, 1.59+/-0.61 mg per g at 30 minutes, 1.07+/-0.30 mg per g at 40 minutes, and 0.96+/-0.26 mg per g at 50 minutes. Approximately 96% of the ethanol is leeched out of the half sclera by 10 minutes and 98% by 20 minutes. CONCLUSIONS: For sclera preserved in 95% ethanol, soaking in balanced salt solution for 20 minutes or longer leeches approximately 98% of the ethanol from the preserved donor sclera.

Drug Residues↗
PubMed1999

Measuring quality in pediatric ophthalmology.

Pediatric ophthalmologists should respond to quality expectations inherent in all disciplines of medicine. The specialists must be able to collect data to document and prove the quality of their work if it anticipates continued reimbursement for services. Quality of medical practice is assessed by outcomes research, which is different from clinical research. All specialists are systemically measuring individual and group outcomes across the spectrum of American health care systems. Pediatric ophthalmologists, both in private practice and at academic centers, must concentrate their research efforts on the assessment of cost, quality, utilization, and patient-centered health-related quality of life for the most common pathologies in pediatric ophthalmology practice.

Child↗
PubMed1997

A southern Illinois eyecare provider survey.

PURPOSE: To determine opinions and knowledge of southern illinois eyecare patients about the different types of eyecare providers and the services they perform. METHODS: A two page survey (Appendix) was presented to 500 consecutive patients registering at the Southern Illinois University Eye Center in April, 1995. Patients were asked to respond to questions which tested their knowledge of the type of provider they were to visit, i.e., ophthalmologist, optometrist, or optician and the services provided. RESULTS: There was pronounced confusion and uncertainty especially with regard to the terms "ophthalmologist" and "optometrist." Approximately one-quarter of those polled believed an optometrist to be a physician, and another one-quarter was unsure. Only one-third of those surveyed reported that "OD" referred to "optometrist." Approximately one-third were unsure if an optician was a physician. Over eighty percent felt there was confusion concerning the different types of eyecare providers and only 49% felt they were well informed with regard to providers and their services. CONCLUSION: The public, even among eyecare patients, is poorly informed with regard to the different types of eyecare providers and their services.

Adult↗
PubMed1997

Case report: unilateral mydriasis from topical Opcon-A and soft contact lens.

The use of topical ocular antihistamine/decongestant combinations to treat symptoms associated with allergic conjunctivitis is widespread, effective, and generally without adverse effects. Recently, these medications have become available without a prescription, possibly leading patients to the erroneous assumption that they are void of side effects. Likewise, patients may use these drugs for many ocular therapies for which they are unintended, possibly resulting in ocular complications. One significant adverse effect of these antihistamine/decongestant combinations when used inappropriately is pupillary dilation with associated blurry vision. Continued emphasis of the possible deleterious side effects by the clinician is recommended to circumvent these problems.

Adult↗
PubMed1994

Screening for ocular toxicity in asymptomatic patients treated with tamoxifen.

Tamoxifen is an antiestrogen drug used in the treatment of patients with breast cancer that is being studied for use in patients at high risk for developing breast cancer. Case reports have documented ocular toxicity caused by tamoxifen in patients with visual symptoms. We attempted to determine the prevalence of ocular toxicity in visually asymptomatic tamoxifen-treated patients. We performed extensive ocular examinations on 135 visually asymptomatic tamoxifen-treated patients. Two patients (1.5%) had intraretinal refractile crystals consistent with tamoxifen retinopathy. Both patients were without visual symptoms or visual loss. Corneal crystals, macular edema, and optic nerve changes were absent. The cumulative tamoxifen doses of these two patients were 10.9 and 21.9 g, respectively. For the 135 patients studied, the mean cumulative dose was 17.2 g, with a standard deviation of 13.0. We do not believe the relatively uncommon finding of tamoxifen-related ocular toxicity merits special screening for such disease.

Adult↗
PubMed1993

Ocular injuries and diseases at a combat support hospital in support of Operations Desert Shield and Desert Storm.

A retrospective review of all emergency department visits to a combat support hospital (one of four combining to support 150,000 troops) during Operations Desert Shield and Desert Storm was conducted, and all medical records of patients with ocular complaints were analyzed. Ocular injury and/or disease accounted for 14% (108/767) of these visits to the emergency department. Of 108 patients with ocular complaints, corneal foreign bodies (18), ocular burns (14), and traumatic iritis (eight) were the most common injuries treated, while blepharitis and conjunctivitis (16) were the most common diseases. Nineteen (18%) of the 108 patients with ocular complaints were treated during support of the ground war in Iraq (13 were Iraqi prisoners). Ophthalmic injuries accounted for 13% (19/149) of all ground war casualties; however, eight individuals had associated injuries deemed more significant than those of ocular concern. This incidence continues the trend of earlier wars, which has demonstrated a steady increase in ocular injuries. Most US Army troops were issued protective goggles, but only three of 92 American patients wore them at the time of their injury and/or disease.

Emergencies↗
PubMed1993

Successful strabismus surgery in a child with Moebius syndrome.

Moebius syndrome is characterized by congenital paralysis, usually bilateral, of the lateral rectus muscles and the muscles of facial expression. Esotropia is common in these patients. Few reports exist of the surgical results after treatment of strabismus in such patients. We report the case of a 19-month-old white boy with Moebius syndrome who demonstrated an A-pattern esotropia with orthotropia in down-gaze. Use of a conventional surgical approach for an A-pattern esotropia and a bilateral medial rectus recession with a one-half tendon-width supraplacement produced the desired result of orthotropia in primary gaze in our patient.

Esotropia↗
PubMed1993

Radial keratotomy in the soldier-aviator.

Radial keratotomy (RK) is an ophthalmological procedure that alters the shape of the cornea, making it "flatter," causing the desired shift to farsightedness. Complications can be minor and "normal" in the immediate post-operative period, or can include problems that occur in many eyes, that persist but do not decrease best corrected visual acuity, or may include events that potentially or actually threaten vision and may produce blindness. At best, only 50% of patients can expect to have 20/20 uncorrected vision 2-3 years after surgery. Diurnal fluctuations in vision (two-five Snellen lines) can persist years after RK. Perhaps 1% of patients may have a two-three Snellen line loss of best corrected vision or ghost images that interfere with clear vision. Disabling glare can disrupt daily activities. Eyes that have undergone RK are at increased risk of corneal rupture after blunt eye trauma. The visual demands of the active duty military, and more dramatically the military aviator, are incompatible with RK. Therefore, RK should not be performed on active duty soldiers, nor should enlistees be accepted if they have undergone the procedure.

Aerospace Medicine↗
PubMed1993

Congenital aplasia of the iris sphincter and dilator muscles.

Congenital aplasia of the iris sphincter and dilator muscles is rare. We describe a 3-month-old boy with a patent ductus arteriosus who had this anomaly, with no other ocular or systemic abnormalities. The child, whom we followed for over 7 years, had reduced accommodative amplitudes. This anomaly, although it bears some similarity to Gillespie's syndrome, circumpupillary aplasia and aniridia, is an isolated, nonprogressive condition that general physicians need to differentiate from the neurologically dilated pupil so that misdirected, unnecessary investigations can be avoided.

Accommodation, Ocular↗